People with swine flu-like symptoms are showing up in all parts of Fort Bend County, a top health official says, and it appears the number of such cases has increased rapidly over the past few days.
But at the same time, a swamped regional testing lab in Houston is following new priority procedures that have more than doubled the time it takes to get results for Fort Bend cases.
As a result, health officials can’t accurately determine how many confirmed cases of the pandemic flu virus Fort Bend County really has.
And in deciding whether to close schools, they’re relying on information about known possible cases of swine flu, and how many people close to the victim are themselves coming down with flu-like symptoms.
In another development, county health officials asked the Fort Bend County Office of Emergency Management to remove one column of figures it began publishing on its web site beginning late last week.
That column showed what was termed “likely” cases of swine flu in various cities in Fort Bend County.
But Kaye Reynolds, deputy director of the Fort Bend County Health & Human Services Department, said the term “likely” isn’t accurate. The cases depicted in the now-missing chart column consisted of known county residents who’d exhibited symptoms associated with Type A influenza.
Reynolds said late seasonal flu, at least two other viral diseases whose victims show flu-like symptoms, and spring allergies, many cases on what OEM had termed the “likely” column are likely not to have swine flu.
But she acknowledged that about half the people represented on the missing chart column have had samples sent to the Houston regional lab for testing to determine whether they have swine flu.
And those numbers appear to be rising dramatically in Fort Bend County.
Screen shots of the chart, obtained by FortBendNow before the OEM removed them from its site, show that 54 cases were in the swine flu “likely” column as of Friday.
But by Monday morning, that number had increased to 153. Of those people with symptoms consistent with Type A flu in Fort Bend County, the cases were listed in the following cities:
- Sugar Land, 43
- Richmond, 34
- Rosenberg, 19
- Missouri City, 16
- Houston, 14
- Fresno, 6
- Stafford, 5
- Katy, 3
- “Unknown,” 2
- Damon, 1
- Meadows, 1
The numbers for Houston reflect that portion of the city within Fort Bend County.
Reynolds said last week she had heard about 1,000 people had samples waiting to be tested at the City of Houston lab – the only one in an 11-county region that’s part of the Centers for Disease Control’s Laboratory Response Network.
But on Tuesday she said up to several hundred samples per day have been sent to the lab each day since.
Now the lab has set up new priorities, the first being hospitalized patients with symptoms consistent with swine flu, who may have been in contact with someone traveling from Mexico or may have been in contact with someone already confirmed to have contracted swine flu.
The next priority is outpatients with symptoms and a situation such as described above for hospitalized patients.
The third priority is patients with Type A flu symptoms from Texas counties that don’t already have a confirmed case of swine flu.
“That puts our cases way down the list,” Reynolds said, adding that it now will take probably well over a week and maybe as long as two weeks to get test results back for cases in Fort Bend County.
County health officials look to the CDC for “guidance” on how to decide when to close schools because of the pandemic flu virus, and much of that guidance is based on the number of confirmed swine flu cases in a school or district.
But with confirmed-case lab results increasingly difficult to obtain, how can such decisions now be made?
“We have been talking to the state a lot about that, especially since the lab results aren’t coming back,” Reynolds said.
Four schools already have closed in Fort Bend County – Lamar Consolidated Independent School District’s Lamar and Bowie junior high schools, both in Rosenberg, Katy ISD’s Beckendorff Junior High, and the private Greatwood Montessori School in Greatwood.
One student each at Lamar, Beckendorff and Greatwood had been judged “highly probable” of having swine flu when decisions to close those schools were made. That means that the Houston lab had identified those students as having a Type A flu of unknown subtype, and had sent their samples on to the CDC. Reynolds has said that about 95% of such samples have tested positive for swine flu.
The current OEM chart shows three confirmed swine flu cases in Fort Bend County and two still listed as probable. Those represent a 17-year-old Fort Bend girl who attends Episcopal High School in Bellaire (which has been closed), one student each attending Lamar, Beckendorff and the Greatwood school, and an unidentified man who is not a student, health officials have said.
At Bowie Junior High, officials decided to close it after it appeared that other people close to a patient-student with Type A flu symptoms also were becoming sick.
With information on confirmed cases coming much more slowly, Reynolds indicated health officials now will make decisions on any school closures based more on patterns. If a student comes down with a high fever and other symptoms that could be swine flu, and then other family members or friends also quickly get sick with similar symptoms, such information could lead to a school closure.
“It’s a difficult decision” to close a school, Reynolds said. “We would all like those lab results.”
The front line of defensive school closures – done in an attempt to lessen the spread of swine flu – is being manned by school nurses.
Reynolds said health officials are relying strongly on the nurses, whom they believe are more familiar with students’ families, and can help judge whether a virus is spreading among family members.
The CDC is telling health officials that in a small school district, one student with a confirmed case of swine flu is enough to shut down the whole district, Reynolds said. In a medium-sized district, two or three closed schools probably should result in closing down the entire district.
In large districts – such as Lamar CISD, Katy ISD and Fort Bend ISD – health officials would be more likely to shut down groups of schools is pandemic flu cases warranted. Such groups would be based on elementary to junior high to high school feeder patterns, Reynolds said.
“We have had influenza-like cases all over the county,” Reynolds said.
“Our recommendation still, to the entire community,” is that anyone who develops a high fever with other flu-like symptoms, “those people need to stay home for seven days.”
They should see their doctor, but not visit an emergency room unless faced with “life-threatening symptoms,” she said.
Globally, the new swine flu virus, which appears to have been seen for the first time in Mexico, has spread to 1,124 confirmed cases in 21 countries.
That includes 727 laboratory-confirmed cases in Mexico, including 26 deaths, and 286 confirmed cases and one death in 36 U.S. states. Forty one of those cases, and the lone death, have been confirmed in Texas.
